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Titolo:
Hypothermia-induced coagulopathy during hemorrhagic shock
Autore:
Krause, KR; Howells, GA; Buhs, CL; Hernandez, DA; Bair, H; Schuster, M; Bendick, PJ;
Indirizzi:
William Beaumont Hosp, Div Trauma Surg, Royal Oak, MI 48073 USA William Beaumont Hosp Royal Oak MI USA 48073 urg, Royal Oak, MI 48073 USA
Titolo Testata:
AMERICAN SURGEON
fascicolo: 4, volume: 66, anno: 2000,
pagine: 348 - 354
SICI:
0003-1348(200004)66:4<348:HCDHS>2.0.ZU;2-U
Fonte:
ISI
Lingua:
ENG
Soggetto:
PLANNED REOPERATION; CIRCULATORY ARREST; INJURED PATIENTS; TRAUMA; SURVIVAL; COAGULATION; LAPAROTOMY; ACIDOSIS; DOGS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
25
Recensione:
Indirizzi per estratti:
Indirizzo: Howells, GA William Beaumont Hosp, Div Trauma Surg, 3601 W 13 Mile Rd, Royal Oak, MI 48073 USA William Beaumont Hosp 3601 W 13 Mile Rd Royal Oak MI USA 48073
Citazione:
K.R. Krause et al., "Hypothermia-induced coagulopathy during hemorrhagic shock", AM SURG, 66(4), 2000, pp. 348-354

Abstract

A porcine model of hemorrhagic shock was used to study the effect of hypothermia on hemodynamic, metabolic, and coagulation parameters. The model wasdesigned to simulate the events of severe blunt injury with hemorrhage occurring initially, to a systolic blood pressure of 30 mm Hg, followed by simultaneous hemorrhage and crystalloid volume replacement, followed by cessation of hemorrhage and blood replacement. Half of the animals were rendered hypothermic by external application of ice, and half remained normothermic,There was seven pigs in each group. Two deaths occurred in each during thehemorrhage phase. The hypothermic pigs demonstrated larger reduction in cardiac output than normothermic pigs. Volume replacement in the normothermicgroup restored cardiac output to baseline values. In the hypothermic group, cardiac output remained depressed despite volume replacement. Prothrombintimes and partial thromboplastin times showed significantly more prolongation in the hypothermic group. Furthermore, this was not corrected by replacement of shed blood in the hypothermic group, as was seen in the normothermic group. We conclude that when shock and hypothermia occur together, theirdeleterious effect on hemodynamic and coagulation parameters are additive. The effects of hypothermia persist despite the arrest of hemorrhage and volume replacement. Thus, it is necessary to aggressively address both shock and hypothermia when they occur simultaneously.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 14/08/20 alle ore 16:54:03